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Functional, metabolic and transcriptional maturation of human pancreatic islets derived from stem cells
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Abstract
Transplantation of pancreatic islet cells derived from human pluripotent stem cells is a promising treatment for diabetes. Despite progress in the generation of stem-cell-derived islets (SC-islets), no detailed characterization of their functional properties has been conducted. Here, we generated functionally mature SC-islets using an optimized protocol and benchmarked them comprehensively against primary adult islets. Biphasic glucose-stimulated insulin secretion developed during in vitro maturation, associated with cytoarchitectural reorganization and the increasing presence of alpha cells. Electrophysiology, signaling and exocytosis of SC-islets were similar to those of adult islets. Glucose-responsive insulin secretion was achieved despite differences in glycolytic and mitochondrial glucose metabolism. Single-cell transcriptomics of SC-islets in vitro and throughout 6 months of engraftment in mice revealed a continuous maturation trajectory culminating in a transcriptional landscape closely resembling that of primary islets. Our thorough evaluation of SC-islet maturation highlights their advanced degree of functionality and supports their use in further efforts to understand and combat diabetes.
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![Fig. 2 Voltage-dependent ion currents, [Ca2+]i oscillations, [cAMP]m signaling and exocytosis in SC-derived and primary islet cells. a, Example membrane potential recording in beta cells of dispersed SC-islets; 10 mM glucose. b–c, Current (I)–voltage (V) relationship in beta cells of dispersed SC-islets (n = 80 cells, eight preparations) or primary islets (n = 39 cells, four donors). Inset shows family of voltage-clamp currents in SC-beta cells (−40 to +10 mV). Average Ca2+ currents (b) and peak Na+ currents (c) (P = 0.002, two-tailed t-test) normalized to cell capacitance (pF). For SC-beta cells, half-maximal current activation was reached at −29 ± 0.9 mV (n = 64) for Ca2+ and at −22.5 ± 0.4 mV (n = 75) for Na+. d–e, Current responses to step-depolarizations (d, ±10 mV around −70 mV, black) or voltage ramps (e, −100 to −50 mV at 100 mV s–1) in controls (Ctrl) or in presence of diazoxide (200 µM) in S7w3 SC-beta cells. f, [Ca2+]i recordings from SC-islets and primary islets exposed to 3 mM (G3) and 16.7 mM glucose (G16.7), 250 µM diazoxide (dz), 1 mM tolbutamide (tol) and 30 mM K+. The uppermost trace shows a quantification from an entire islet and the traces below are representative examples from cell-sized regions of interest. g, Histograms showing the changes of [Ca2+]i in response to various treatments normalized to the levels at G3 in cells from SC-islets (n = 5,254) and primary islets (n = 3,550). h, [Ca2+]i recording specifically from insulin-expressing SC-beta cells using RIP2-R-GECO1. Relative fluorescence changes as a function of time with each line representing one cell. i–j, Representative [cAMP]m recordings from cells in intact SC- (i) and primary (j) islets stimulated with G16.7 and 10 nM exendin-4 (Ex4). k, The effects of G16.7 and Ex4 from experiments as in i and j in SC-islets (n = 119 cells from six independent experiments) and primary islets (81 cells from three preparations) ** P < 0.01 versus G3; ## P < 0.01 versus G16.7, two-tailed Student’s paired t-test. l, Cell capacitance increase (ΔCm) during a train of 14 × 200 ms depolarizations from −70 mV to 0 mV in SC-beta cells and primary beta cells. m, Average change in membrane capacitance, normalized to initial cell capacitance (ΔC/C0), during the first depolarization (no. 1), and total increases during the train (Σ1–14) for SC-beta (n = 80 cells, eight preparations) and primary beta cells (n = 39 cells, four preparations). Dots represent individual cells and lines the mean values. n, Representative TIRF images of SC-beta cells expressing the granule marker NPY-tdmOrange2 in absence (top) or presence of Ex4 (bottom), and before (left) and after (right) stimulation with elevated K+ (in G10 + diazoxide). Scale bar, 2 µm. o, Cumulative timecourse of high K+-evoked exocytosis events normalized to cell area, from experiments as in n, for control (68 cells) and Ex4 (71 cells); two-tailed t-test. Shaded areas indicate s.e.m. p, Total K+ depolarization-induced exocytosis in o. q, Spontaneous exocytosis (normal K+, no diazoxide, normalized to cell area) during a 3-min observation period after >20 min preincubation at G3 or G10. Fusion events were quantified in SC-beta cells at S7w0 (13 cells at G3 and 12 at G10) and at S7w6 (40 cells at G3 and 41 at G10) and normalized to the cell area. In p and q, dots represent averages for individual SC-islet batches. All data presented as means ± s.e.m. unless otherwise indicated.](/paper-figures/fc4aa379d51e493696118704cd30f208/functional-metabolic-and-transcriptional-maturation-of-human-pancreatic-islets-figure-2.jpg)

![Fig. 4 Metabolic tracing analysis of maturing SC-islets. a, Left, Overview of experimental setup. SC-islets or adult islets were exposed to low (3 mM) or high (17 mM) concentrations of uniformly labeled [U-13C6] glucose for 1 h before metabolite extraction and liquid-chromatography mass spectrometry (LC-MS) detection. Right, An example of isotopologue nomenclature and glucose-derived labeling of downstream metabolites. b, The ratio of M+6 G6P to M+6 labeled glucose under low and high glucose concentrations in adult islets and SC-islets over 6 weeks of maturation. c, The relative abundances of fully labeled glycolytic intermediates in SC-islets and adult islets following low and high labeled glucose treatment. d, The M+3 lactate content of adult islets and SC-islets detected over the timecourse of maturation, following low and high labeled glucose treatment. e, The percentage of total serine and glycine labeled from 13C-glucose following low and high glucose treatment of SC- and adult islets. f, Ratiometric analysis of labeled lactate to labeled pyruvate, and labeled citrate to labeled pyruvate under high glucose treatment in SC-islets and adult islets. g, The combined percentage of labeled TCA metabolites (M+2 to fully labeled M+n) from SC- and adult islets after low and high labeled glucose treatment. h, The combined abundance of aspartate (M+2 to M+4) and glutamate (M+2 to M+5) isotopologues in SC-islets (w0–w6) under low and high glucose concentrations, relative to adult islets. i, The combined relative abundance of M+2 to M+5 GSH isotopologues under low and high labeled glucose concentrations in adult islets and SC-islets. j, Schematic overview of active glucose metabolic pathways in SC-islets and adult islets. Arrow thickness denotes the extent of glucose-derived carbons entering the pathway. Error bars ± s.e.m. with statistical significance determined by two-tailed t-tests. Hash symbols indicate internal significance from low to high glucose labeling, asterisks denote significance between SC-islet timepoints or adult islet samples at each glucose concentration. #,*P < 0.05, ##,**P < 0.01, ###,***P < 0.001. SC-islets S7w0 (n = 4), S7w3 (n = 12–13), S7w6 (n = 3), adult islets (n = 6).](/paper-figures/023e8ee4039546b4b620d219fc425b37/functional-metabolic-and-transcriptional-maturation-of-human-pancreatic-islets-figure-4.jpg)


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“These cells have been subsequently identified in SC-islets generated from various differentiation protocols and stem cell lines by multiple groups.”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Specifically, known markers of β cell maturation, such as INS, MAFA, IAPP, MNX1, and G6PC2, became more highly expressed in a greater proportion of SC-islet cells after transplantation.”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Transplantation of SC-islets into mice improves their insulin secretion and glucose responsiveness, suggesting that SC-islet immaturity can be resolved.”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“These transcriptional changes appeared to occur temporally, as some genes (e.g., G6PC2) increased in expression shortly after transplantation, while others (e.g., MAFA) took several months to upregulate.”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Overall, comparison of scRNA-seq and snATAC-seq data from transplanted SC-islets and primary islets has indicated that SC-islets become more similar to human islets overtime in vivo in terms of both their transcriptional and chromatin accessibility profiles, though some important differences still remain.”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
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“These cells have been shown to improve glycemic control in diabetic mice, highlighting their potential utility in vivo.36,37,39–44”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
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“and recent advances in single-cell sequencing technologies have allowed for unprecedented characterization of these cells to further elucidate ways to refine SC-β cell differentiation strategies.43,47,50,51”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
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“scRNA-seq analysis of transplanted SC-islets revealed that improved function corresponded with transcriptional maturation.”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
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“This differentiation methodology takes approximately a month or more to complete, and functional maturation can continue for months once the cells are transplanted in vivo.43,51”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
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“Despite transcriptional improvements, SC-islets nonetheless had significantly reduced activity of metabolic pathways compared to primary islets.”
From Developments in stem cell-derived islet replacement therapy for treating type 1 diabetes (2023) · cites this paper as [43]
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Metadata
- Authors
- Balboa, D., Barsby, T., Lithovius, V., Saarimäki-Vire, J., Omar-Hmeadi, M., Dyachok, O., Montaser, H., Lund, P.-E., Yang, M., Ibrahim, H., Näätänen, A., Chandra, V., Vihinen, H., Jokitalo, E., Kvist, J., Ustinov, J., Nieminen, A. I., Kuuluvainen, E., Hietakangas, V., Katajisto, P., Lau, J., Carlsson, P.-O., Barg, S., Tengholm, A., & Otonkoski, T.
- Affiliations
- University of Helsinki (FI)
- Uppsala University (SE)
- Institute for Molecular Medicine Finland (FI)
- Corresponding author
- Otonkoski, Timo
- ORCID
- Balboa, Diego
- Barsby, Tom
- Lithovius, Väinö
- Saarimäki-Vire, Jonna
- Omar-Hmeadi, Muhmmad
- Dyachok, Oleg
- Montaser, Hossam
- Lund, Per-Eric
- Yang, Mingyu
- Ibrahim, Hazem
- Chandra, Vikash
- Vihinen, Helena
- Jokitalo, Eija
- Kvist, Jouni
- Nieminen, Anni I.
- Kuuluvainen, Emilia
- Hietakangas, Ville
- Katajisto, Pekka
- Lau, Joey
- Carlsson, Per-Ola
- Barg, Sebastian
- Tengholm, Anders
- Otonkoski, Timo
- Venue
- Nature Biotechnology
- Published
- 2022-03-03
- Volume
- 40
- Issue
- 7
- Pages
- 1042-1055
- ISSN
- 0733-222X (ISSN-L)
- 1087-0156
- 1546-1696
- PMC
- PMC9287162
- OpenAlex
- W4214950345
- Cited by
- 433
- References
- 106
- Citations by year
- 2026: 95 · 2025: 96 · 2024: 113 · 2023: 88 · 2022: 35
- FWCI
- 81.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Nature Biotechnology (publishedVersion, cc-by)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Työväentutkimus Vuosikirja (submittedVersion)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by)
- Funders
- Leona M. and Harry B. Helmsley Charitable Trust (115797)
- European Federation of Pharmaceutical Industries and Associations (115797)
- University of Alberta
- Academy of Finland (297466, 312437)
- Novo Nordisk
- Vetenskapsrådet
- Barndiabetesfonden
- Sigrid Juséliuksen Säätiö
- Stiftelsen Familjen Ernfors Fond
- Novo Nordisk Fonden (NNF20OC0063654, NNF15OC0016260, NNF20OC0064000, NNF19OC0057286, NNF18OC0034450, NNF14OC0010001, NNF17OC0027344)
- Innovative Medicines Initiative (115797], 945268)
- Diabetes Wellness Suomi Säätiö
- Biocenter Finland
- Helsinki Institute of Life Science, Helsingin Yliopisto
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Pluripotent Stem Cells Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- islet maturation, diabetes mellitus, glucose-stimulated insulin secretion, alpha cells, exocytosis, glycolytic metabolism, single-cell transcriptomics, islet engraftment, islet transplantation, pluripotent stem cells
- MeSH terms
- Animals, Glucose, Humans, Insulin, Islets of Langerhans, Islets of Langerhans Transplantation, Pluripotent Stem Cells, Mice
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